奥氮平和丙戊酸钠治疗双相抑郁的疗效及安全性

 目的 探讨奥氮平和丙戊酸钠治疗双相抑郁的疗效及安全性。方法 时长8周的随机双盲对照研究。将69例符合DSM-IV双相抑郁诊断标准的患者随机分为奥氮平组与丙戊酸钠组,在基线和治疗期每周末采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、蒙哥马利抑郁量表(MADRS)、贝克-拉范森躁狂评定量表(BRMS)、临床疗效总评量表(CGI-I)和治疗不良反应(TESS)进行评定。结果 两组治疗后HAMD、HAMA评分均较治疗前显著降低(P<0.01),两组间减分率差异无统计学意义,奥氮平组和丙戊酸钠有效率分别为82.86％、82.35％,痊愈率为37.14%、38.24%,有效率及痊愈率差异均无统计学意义,但奥氮平起效更为迅速。结论 奥氮平可有效治疗双相抑郁。

Efficacy and safety of olanzapine and sodium valproate monotherapy in the treatment of bipolar depression:a flexible-dose randomised,double-blind study

Objective To assess the efficacy and safety of olanzapine andsodium valproate monotherapy for bipolar depression. Methods Seventy-one patients who met DSM-IV criteria for bipolar depression were randomly assigned to treatment with olanzapine (n=35) or sodium valproate(n=36) in a double-blind parallel-group study design. The treatment duration was 8weeks.Planned assessments included Bech-Rafaelsen Mania Rating Scale(BRMs), Clinical Global Impressions-Improvement Scale (CGI-I), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Treatment Emergent Symptom Scale(TESS). Results Improvements in MADRS total score, CGI-I, and HAMD in the olanzapine group were not significantly different relative to those in the sodium valproate during the 8-week follow-up period (P<0.01, P=0.0017, P=0.007, and P<0.01, respectively).The rate of response(82.86％ and 55.88％,respectively)and remission(37.14％ and 26.47％,respectively)in olanzapine group and sodium valproate group,showed no statistically significant difference. But,olanzapine-treated group had a more rapid onset of effect than sodium valproate-treated patients in score of HAMA,with significant difference between two groups(P<0.01). Conclusions Olanzapine monotherapy is effective in the treatment of bipolar depression.